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Tonetti Et Al-2015-Journal of Clinical Periodontology
Tonetti Et Al-2015-Journal of Clinical Periodontology
Tonetti Et Al-2015-Journal of Clinical Periodontology
12368
Principles in prevention of
periodontal diseases
Consensus report of group 1 of
the 11th European Workshop on
Periodontology on effective
prevention of periodontal and
peri-implant diseases
Tonetti MS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G,
Bouchard P, Deinzer R, Dietrich T, Hughes F, Kocher T, Lang NP, Lopez R,
Needleman I, Newton T, Nibali L , Pretzl B, Ramseier C, Sanz-Sanchez I,
Schlagenhauf U, Suvan JE, Fabrikant E, Fundak A. Principles in prevention of
periodontal diseasesConsensus report of group 1 of the 11th European workshop
on periodontology on effective prevention of periodontal and peri-implant diseases.
J Clin Periodontol 2015; 42 (Suppl. 16): S5S11. doi: 10.1111/jcpe.12368.
Abstract
Aims: In spite of the remarkable success of current preventive efforts, periodontitis remains one of the most prevalent diseases of mankind. The objective of this
workshop was to review critical scientific evidence and develop recommendations
to improve: (i) plaque control at the individual and population level (oral
hygiene), (ii) control of risk factors, and (iii) delivery of preventive professional
interventions.
Methods: Discussions were informed by four systematic reviews covering aspects
of professional mechanical plaque control, behavioural change interventions to
improve self-performed oral hygiene and to control risk factors, and assessment
of the risk profile of the individual patient. Recommendations were developed
and graded using a modification of the GRADE system using evidence from the
systematic reviews and expert opinion.
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Tonetti et al.
2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Group 1 consensus
Secondary prevention of periodontitis refers to preventing recurrence of
gingival inflammation, which may
lead to additional attachment loss in
successfully treated periodontitis.
Both at the population and at the
individual subject level, prevention
(and treatment) of gingivitis is a critical component for the prevention of
periodontitis. Furthermore, the control/
management of risk factors for
periodontitis such as smoking and
diabetes form an important part of
prevention of periodontitis.
Prevention of periodontal disease
consists of patient-performed control
of the dental biofilm and professional interventions. In developed
countries, the above approaches have
been used for several decades. Their
application at the population level
has been associated with an overall
improvement in the levels of oral
cleanliness, a decrease in gingival
inflammation and in the prevalence
of mild to moderate periodontitis
(Eke et al. 2012). In the majority of
these countries, however, the prevalence of severe periodontitis has not
decreased.
Similar to approaches adopted in
the prevention of other common
chronic diseases, effective prevention
of periodontitis requires the combined involvement of policy makers,
health professionals and empowered
individuals.
It is noted that the oral health
care team comprises different professional figures in different countries.
These should participate in the
professional delivery of prevention
as determined by the competent governing laws.
The aim of this consensus was to
identify effective approaches to
improve: (i) plaque control at the
individual and population level (oral
hygiene), (ii) control of risk factors,
and (iii) preventive professional
interventions.
The scope of this consensus is
to review the evidence supporting
approaches for the prevention of
periodontal diseases in self-caring
adults without disabilities and to
provide specific recommendations to
the public, oral health professionals
and policy makers. Specific recommendations were developed based on
the evidence and the expert opinion
of the group participants. Each recommendation for oral health care
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Recommendations
2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Research
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Tonetti et al.
investigated, including frequency,
types of interventions, patient
reported outcome measures and
health economics.
There is a need to investigate
whether there is a threshold of
gingival inflammation (in terms
of both severity and duration)
which is compatible with longterm periodontal health.
Psychological Approaches to
Behavioural Change for Improved
Plaque Control in Periodontal
Management
to
periodontitis and
their benefits from change,
Based on this evidence a reasonable approach to facilitate behavioural change with oral hygiene practices
is the incorporation of Goal setting,
Planning and Self-monitoring (GPS).
Related to patient-perceptions of
harmful consequences,
their own susceptibility
Recommendations
Facilitated by
goal setting (i.e., identifying
2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Group 1 consensus
evidence that brief interventions in
the dental setting increase the smoking cessation rate. While the reported
quit rate was in the range of 1020%
at 12 months (Carr & Ebbert 2012),
the magnitude of the effect seen in
these studies is comparable to that
described in similar studies in general
health care settings (Fiore et al.
2008). Six of the eight studies in the
review that supported the effectiveness of brief interventions to quit
smoking in the dental setting were
performed in the dental office.
Evidence
demonstrates
that
patients welcome and expect involvement of oral health professionals in
smoking cessation.
A limitation of the evidence is the
lack of consistency of definition of
specific interventions in the dental
setting. However, a brief intervention
in this context is generally a short
conversation with the patient of up to
5 min., which provides advice and
includes a degree of counselling
regarding tobacco use.
Recommendations
tobacco use)
2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
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Tonetti et al.
Recommendations
2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Principles in prevention of
periodontal diseases
Consensus report of group 1 of
the 11th European Workshop on
Periodontology on effective
prevention of periodontal and
peri-implant diseases
Tonetti MS, Eickholz P, Loos BG, Papapanou P, van der Velden U, Armitage G,
Bouchard P, Deinzer R, Dietrich T, Hughes F, Kocher T, Lang NP, Lopez R,
Needleman I, Newton T, Nibali L , Pretzl B, Ramseier C, Sanz-Sanchez I,
Schlagenhauf U, Suvan JE, Fabrikant E, Fundak A. Principles in prevention of
periodontal diseasesConsensus report of group 1 of the 11th European workshop
on periodontology on effective prevention of periodontal and peri-implant diseases.
J Clin Periodontol 2015; 42 (Suppl. 16): S5S11. doi: 10.1111/jcpe.12368.
Abstract
Aims: In spite of the remarkable success of current preventive efforts, periodontitis remains one of the most prevalent diseases of mankind. The objective of this
workshop was to review critical scientific evidence and develop recommendations
to improve: (i) plaque control at the individual and population level (oral
hygiene), (ii) control of risk factors, and (iii) delivery of preventive professional
interventions.
Methods: Discussions were informed by four systematic reviews covering aspects
of professional mechanical plaque control, behavioural change interventions to
improve self-performed oral hygiene and to control risk factors, and assessment
of the risk profile of the individual patient. Recommendations were developed
and graded using a modification of the GRADE system using evidence from the
systematic reviews and expert opinion.
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